Individual
KIMEYA GHADERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
277530
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2016
Last updated
05/05/2021
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